| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0150 |
Comprehensive oral evaluation - new or established patient |
82,055 |
77,057 |
$3.32M |
| D8670 |
Periodic orthodontic treatment visit |
40,217 |
35,134 |
$3.27M |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
24,417 |
13,484 |
$3.17M |
| D1330 |
|
164,146 |
153,628 |
$2.97M |
| D0330 |
Panoramic radiographic image |
48,418 |
45,388 |
$2.48M |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
37,145 |
20,430 |
$1.85M |
| D1110 |
Prophylaxis - adult |
58,585 |
54,756 |
$1.83M |
| D0230 |
Intraoral - periapical each additional radiographic image |
288,502 |
145,700 |
$1.65M |
| D0120 |
Periodic oral evaluation - established patient |
114,670 |
107,151 |
$1.58M |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
44,768 |
39,017 |
$1.21M |
| D0210 |
Intraoral - complete series of radiographic images |
12,548 |
12,247 |
$981K |
| D7140 |
Extraction, erupted tooth or exposed root |
27,727 |
16,192 |
$788K |
| D1120 |
Prophylaxis - child |
145,304 |
136,170 |
$781K |
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
1,386 |
1,140 |
$692K |
| D0140 |
Limited oral evaluation - problem focused |
25,295 |
23,736 |
$633K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
3,646 |
2,676 |
$543K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
14,404 |
8,777 |
$479K |
| D1351 |
Sealant - per tooth |
108,862 |
27,271 |
$417K |
| D0274 |
Bitewings - four radiographic images |
82,720 |
77,365 |
$400K |
| D1208 |
Topical application of fluoride, excluding varnish |
183,229 |
171,531 |
$391K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
8,624 |
4,600 |
$383K |
| D8660 |
|
3,184 |
2,863 |
$213K |
| D0220 |
Intraoral - periapical first radiographic image |
174,587 |
160,775 |
$176K |
| D1510 |
|
682 |
544 |
$146K |
| D2160 |
|
1,776 |
1,275 |
$145K |
| D9999 |
Unspecified adjunctive procedure, by report |
5,957 |
5,953 |
$137K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
11,439 |
7,267 |
$118K |
| D2740 |
Crown - porcelain/ceramic |
417 |
322 |
$107K |
| D2751 |
Crown - porcelain fused to predominantly base metal |
399 |
308 |
$93K |
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
109 |
101 |
$79K |
| D2950 |
|
889 |
681 |
$72K |
| D0272 |
Bitewings - two radiographic images |
51,580 |
48,371 |
$69K |
| D9420 |
|
310 |
277 |
$42K |
| D0603 |
|
1,733 |
1,730 |
$36K |
| D9239 |
|
37 |
35 |
$28K |
| D9430 |
|
2,029 |
1,963 |
$26K |
| D0601 |
|
985 |
982 |
$25K |
| D0999 |
Unspecified diagnostic procedure, by report |
1,223 |
1,223 |
$25K |
| D9310 |
|
825 |
803 |
$25K |
| D1999 |
|
603 |
603 |
$24K |
| D2931 |
|
129 |
112 |
$19K |
| D2140 |
|
502 |
324 |
$15K |
| D2954 |
|
221 |
163 |
$14K |
| D1354 |
|
6,600 |
1,781 |
$11K |
| D2332 |
|
143 |
90 |
$8K |
| D2330 |
|
616 |
339 |
$8K |
| D0270 |
|
1,844 |
1,747 |
$7K |
| D3120 |
|
1,843 |
1,262 |
$5K |
| D0145 |
Oral evaluation for a patient under three years of age |
201 |
199 |
$3K |
| D7111 |
|
73 |
40 |
$2K |
| D9243 |
|
51 |
35 |
$2K |
| D0602 |
|
14 |
14 |
$1K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
61 |
30 |
$1K |
| D2331 |
|
71 |
42 |
$1K |
| D1206 |
Topical application of fluoride varnish |
140 |
139 |
$814.56 |
| D0240 |
|
40 |
31 |
$491.18 |
| D9995 |
|
39 |
28 |
$275.67 |
| D9920 |
|
42 |
42 |
$0.00 |
| D7230 |
|
31 |
15 |
$0.00 |
| D3110 |
|
16 |
13 |
$0.00 |
| D0460 |
|
13 |
13 |
$0.00 |
| D0425 |
|
21 |
19 |
$0.00 |